title: Gene hunting in the genomic era: approaches to diagnostic dilemmas in patients with primary immunodeficiencies.
abstract: There are more than 180 different genetic causes of primary immunodeficiencies identified to date. Approaches for identifying causative mutations can be broadly classified into 3 strategies: (1) educated guesses based on known signaling pathways essential for immune cell development and function, (2) similarity of clinical phenotypes to mouse models, and (3) unbiased genetic approaches. Next-generation DNA sequencing permits efficient sequencing of whole genomes or exomes but also requires strategies for filtering vast amounts of data. Recent studies have identified ways to solve difficult cases, such as diseases with autosomal dominant inheritance, incomplete penetrance, or mutations in noncoding regions. This review focuses on recently identified primary immunodeficiencies to illustrate the strategies, technologies, and potential pitfalls in finding novel causes of these diseases.
authors.affiliation: Division of Immunology and the Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
authors.forename: Craig
authors.initials: C
authors.lastname: Platt
authors.affiliation: Division of Immunology and the Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
authors.forename: Raif S
authors.initials: RS
authors.lastname: Geha
authors.affiliation: Division of Immunology and the Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass. Electronic address: janet.chou@childrens.harvard.edu.
authors.forename: Janet
authors.initials: J
authors.lastname: Chou
mesh_terms: D000818:Animals; D059472:Exome; D005786:Gene Expression Regulation; D005817:Genetic Counseling; D008040:Genetic Linkage; D023281:Genomics / Q000379:methods*; D005838:Genotype; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D051379:Mice; D010375:Pedigree; D010641:Phenotype; D015398:Signal Transduction
keywords: Primary immunodeficiencies; homozygosity mapping; linkage analysis; whole-exome sequencing; whole-genome sequencing